Resources in Workplace Accommodation
Contributors: Malachy Bishop, PhD, CRC, Coordinator, Associate Professor, Rehabilitation Counseling
Program, University of Kentucky and Erica Johnson, PhD, CRC, University of Washington Department
of Rehabilitation Medicine
This module presents resources and current information about workplace accommodations. Although jobsite accommodation or "reasonable accommodation" is discussed throughout the modules in this Web site, this particular module deals with accommodation perspectives and resources in detail. Topics include:
1. Understanding workplace accommodations
2. How are decisions made about what accommodations are needed?
3. What are some points to remember about disclosure and accommodations?
4. What do accommodations cost and who has to pay for them?
5. Examples of epilepsy-related workplace accommodations
6. Stories of successful accommodations from the Job Accommodation Network
7. Accommodation resources
Understanding workplace accommodations
What is an accommodation?
A work-related accommodation is any change or adjustment to a job, the work environment, or the
manner in which a job is done. Accommodation enables the person with a disability to:
- apply for a job,
- perform a job, or
- enjoy equal access to benefits of the job that are available to other individuals in
The purpose of work accommodations is to ensure that persons with disabilities have equal
opportunities to participate in employment.
Most people with epilepsy do not need accommodations to do their jobs. For those who do need
an accommodation, the accommodations will vary depending on the needs of the individual and
the job demands. It is helpful to conceptualize accommodations in these categories: a change
in procedure (how the job is being done), modification to the work station, or the provision of
some type of assistive equipment.
How are people with epilepsy eligible for a workplace accommodation?
- The Americans with Disabilities Act (ADA) of 1990 provides civil rights protections to
individuals with disabilities similar to those provided to individuals on the basis of race,
color, sex, national origin, age, and religion.
- The ADA prohibits discrimination in all employment practices, including: job application
procedures, hiring, firing, advancement, compensation, training, and other terms, conditions,
and privileges of employment.
- The ADA applies to recruitment, advertising, tenure, layoff, leave, fringe benefits, and all
other employment-related activities.
- The ADA defines and individual with a covered disability as one who has a physical or mental impairment that substantially limits a major life activity, as well as those with a record of, or are regarded as having, such an impairment. Under the Americans with Disabilities Act Amendments Act (ADAAA) of 2008 (which became effective January 1, 2009), al persons with epilesy should be considered to have a disability covered under the ADA, and therefore will be protected from employment discrimination.
- The ADAAA was enacted in part to address several Supreme Court decisions that greatly restricted the application of the ADA to persons with epilepsy and certain other conditions. Under these decisions, the Court had interpreted the ADA as inapplicable to conditions that are controlled with medication or other measures or which do not severely restrict major life activities (e.g. seeing, hearing, breathing, working, walking). As a result, the lower courts found that the large majority of persons with epilepsy whose conditions were controlled with medication were not protected under the law. The ADAAA effectively reversed these decisions by amending the ADA to clarify that the effects of medication or other measures will not be considered in determining whether an individual has a disability; the law also clarifies that conditions which limit bodily functions, including the neurological system, are covered disabilities, and that episodic conditions are also covered if they are substantially limiting in their active state (such as epilepsy).
- A qualified individual with a disability (that affects one or more major life areas) is one who
can perform the essential functions of the job (i.e. functions that are clearly central to the job)
with or without accommodation.
It is the employee’s decision to request an accommodation from the employer. Once a request has
been made, the employer and employee should consider the following:
- What are the functional limitations of the person asking for the accommodation?
- What specific job tasks are affected by those functional limitations?
- Are there workplace policies or procedures that affect the person’s ability to do the job?
- What types of equipment are used/needed to perform the job?
- The individual's physician or neurologist can play an important role in the accommodation process.
- The job description may assist medical providers in providing input.
- Accommodations may be simple, inexpensive and commonsense, such as using a day planner as a memory aid.
Examples of workplace accommodations for people with epilepsy are provided further along in this section. Jump to examples.
When may an employer make inquiries about epilepsy or require physical examinations?
The ADA sets a number of restrictions on medical inquiries and examinations, which vary depending on the stage of the employment process:
- Prior to the offer of a job – an employer may not ask whether an applicant has epilepsy or another disability, inquire about the severity of a disability, or make any inquiry that is likely to elicit information about a disability. An employer, however, may request applicants to indicate any accommodations they may need to take a pre-employment test.
- Conditional job offer – an employer who believes that an applicant satisfies the requirements of a position may offer the applicant a job conditioned on the satisfactory outcome of a medical examination or inquiry, as long as all applicants in that job class or category are required to undergo such an exam or inquiry. Such an exam or inquiry need not focus on the ability to perform job functions, but may explore any information the employer believes is relevant to a person’s ability to perform a job, including information about disability.
- After employment begins – an employer may make disability-related inquiries and require medical examinations only if they are "job-related and consistent with business necessity." This means that the employer must have a reasonable belief based on objective evidence that an employee will be unable to perform the essential functions of his or her job because of a medical condition or that the employee will pose a threat to health or safety because of a medical condition.
- Requesting an accommodation – an employer may require an applicant who requests an accommodation to substantiate that his/her condition is a disability covered under the ADA or the state’s antidiscrimination law and that the accommodation is necessary.
When might an applicant or employee want to voluntarily disclose his or her epilepsy?
If epilepsy is not affecting job performance or relationships in the workplace, it is generally inadvisable to disclose the condition – because discrimination, unfortunately, remains a real possibility. The decision to disclose is a personal one that should be based on a weighing of the potential costs and benefits, including:
- Need for accommodation to perform the job
- Need for accommodation to avoid discipline or termination
- Need for accommodation to protect health and safety
- Whether modification may be obtained without disclosing disability
- Risk of stigma and harassment
- Risk of loss of privacy
An employee may want to approach his/her employer about developing a voluntary workplace assistance. On this issue, the EEOC’s guidance on epilepsy in the workplace (www.eeoc.gov/facts/epilepsy.html) notes that:
Although many individuals who have seizures do not require any first aid or assistance, an employee who might need assistance may want to work with his employer to create a plan of action that includes such information as: who to contact in an emergency; warning signs of a possible seizure; how and when to provide assistance; when to call an ambulance, etc. The employee and employer also should discuss who in the workplace should know this information. Some individuals also might want to ask their employers for an opportunity to educate their co-workers about epilepsy to dispel any misperceptions or unsubstantiated fears they may have about the condition.
- Remember that discrimination in employment against people with disabilities, including those with epilepsy, who can do the essential functions of the job, with or without accommodations, is illegal, under provisions of the Americans with Disabilities Act (ADA) of 1990.
- Under the ADA and state law, an employer who is a covered entity (15 or more employees
under federal law, fewer under many state laws) may be required to pay for a reasonable accommodation that is necessary for a qualified individual to do the job.
- "Reasonable" is not defined, but is based on administrative regulations and case law. It depends on the size of the employer, amount of revenue and other factors. The reasonable accommodation cannot impose an undue hardship on the employer.
- The employee can request that the employer pay for or assist with the accommodation, seek funds from a state vocational rehabilitation agency to pay for it, or in some circumstances, may pay for it themselves. Depending upon company size, a tax deduction or credit can be taken by the employer for accommodation costs.
To whom do employees make a request for accommodation?
- In a large organization, the individual would usually make this request to the Human Resources
department. Some large employers (e.g., Bank of America) actually have an accommodations
resource center and the cost of accommodation(s) can be supported by this national center.
- In smaller organizations, the request may be made to the responsible supervisor.
- Some large employers also have a Disability Services Unit with vocational rehabilitation counselors
on staff or a disability consultant on contract.
What should be included in the request for accommodation?
In requesting a reasonable accommodation, the employee does not need to use any magic words, such as "disability" or "reasonable accommodation." From a practical standpoint, however, the employee may wish to use words such as "disability," "impairment," "limiting," "major life activity" and "accommodation." It is also preferable, but not required, that the request be provided in writing (this may help avoid disputes in the future).
According to guidance issued by the EEOC, if an individual’s epilepsy-related limitations or the need for the accommodation is not obvious, the employer may request "reasonable documentation" showing the employee’s right to accommodation. Reasonable documentation means documentation from an appropriate health care professional (e.g., a physician’s note) that verifies the disability and the need for the accommodation. Absent usual circumstances, a request for a complete release of medical records exceeds the employer’s legitimate need for information, and is not permitted. According to the EEOC, documentation under the ADA is sufficient if it (1) describes the nature, severity, and duration of the employee’s impairment, the activity or activities that the impairment limits, and the extent to which the impairment limits the employee’s ability to perform the activity or activities; and (2) substantiates why the requested accommodation is needed.
Responding to a request for accommodation
- Though ultimately it is the employer’s decision as to which accommodation to offer, under the ADA, the employer typically must engage in a good faith effort and work in cooperation with the employee to identify a reasonable accommodation. This "interactive process" is intended to be informal and flexible so as to respond to the unique needs and abilities of individual employees.
- Among other steps, the process should involve consulting with the individual to be accommodated, identifying potential accommodations and assessing the effectiveness each would have in enabling the individual to perform the essential functions of the position (giving preference, if possible, to the individual’s requested accommodation)
- Additionally, in some instances, it may be necessary for the employer to consult qualified experts to gather the information needed to identify an appropriate reasonable accommodation, including the employee’s physician, rehabilitation specialists, and others with expert knowledge about dealing with epilepsy in the workplace.
- If a local accommodations consultant is not available, or if the employer cannot find technical
assistance, no-cost consultation resources such as the Job Accommodation Network (JAN), or regional Disability and Technical Assistance Centers (DBTACs) can be utilized. Both JAN and DBTACs are sponsored by federal agencies—The Department of Labor and the National Institute on Disability and Rehabilitation Research (NIDRR) respectively. Please see Accommodation Resources at the end of this module for contact information.
Who might assist in developing a personal accommodation plan?
Among those who can assist, depending on the individual’s needs, are a certified rehabilitation counselor, a speech and language pathologist familiar with neurological and cognitive rehabilitation, a rehabilitation psychologist or neuropsychologist, an assistive technologist, or other professionals recommended by your health care provider, state rehabilitation agency, or local Epilepsy Foundation affiliate. (http://www.epilepsyfoundation.org/).
- According to Job Accommodation Center research, most employers report financial benefits from
providing accommodations due to a reduction in the cost of training new employees, a reduction
in the cost of insurance, and an increase in worker productivity.
- Often the accommodation needed is simply a procedural change, for example, modifying a work
schedule or duties such as driving.
- Again costs may be covered by the employer, by the employee, by a state vocational rehabilitation agency, or by some combination thereof. Depending upon size of company, the employer may be able to take a tax deduction or credit for accommodation efforts.
- As businesses become more knowledgeable about the requirements of the Americans with Disabilities Act, many are able to make simple adjustments to the worksite with little or no advice from others.
- Recent JAN data show that 20% of accommodations cost nothing, and another 60% cost less than $500.
- A requested accommodation that might appear too costly does not have to be accepted by the
employer. The employer is free to explore other less expensive alternatives if they work just as well. It is also important to remember that accommodations or adjustments must be made on a case-by-case basis.
Most people with epilepsy do not need accommodations to do their jobs. For those who do, the following
examples of epilepsy-related workplace accommodations are provided. Many of these represent workplace practices that may increase the safety and efficiency of all employees.
Accommodations related to safety
- Designate a person to respond to emergencies and know when to call 911 (making a seizure-related call only after several minutes of seizure activity)
- Provide a quick, unobstructed exit and post clearly marked directions for exits, fire doors, etc.
- Provide relevant education/sensitivity training to employees.
Accommodations related to seizures on the job
- Try to reduce or eliminate situations that may make seizure activity more likely to occur. Some
potential seizure triggers include: disruption in daily activities due to working varied shifts (such as sleeping, taking medications, or eating), extreme stress on the job.
- Allow employee time to recuperate from seizure.
- Educate coworkers and supervisors on how to respond/react when employee has a seizure on the job.
- Consult employee’s plan of action to determine how to respond/react when employee has a seizure on the job (again not making the 911 call too quickly).
Accommodations related to Driving
- Pair employee with co-worker who can drive to meetings or events.
- If driving is not an essential job function, reassign it to another employee.
- Transfer employee to a position that does not require driving.
- Adjust schedule so employee can access public transportation.
- Form a carpool with co-workers (to/from work).
Accommodations related to balancing/climbing
- Use rubber matting on floor area to cushion a potential fall.
- Use stepping stands with handrails and rolling safety ladders.
- Reassign this duty to another employee if climbing is not an essential job function.
- Provide head, eye, and harness protection.
- Have deep arm rests on chairs to prevent falling out of chair.
Accommodations related to fatigue (physician consult can also be sought for anti-fatigue medication)
- Use anti-fatigue matting on the floor.
- Provide flexible start or ending times.
- Adjust workweek.
Accommodations related to photosensitivity
- Use flicker-free monitor (LCD display, flat screen), monitor glare guard, "computer glasses," and
take frequent breaks from tasks involving the computer.
- Replace fluorescent lights with full spectrum lighting, use desk or floor lamps, and use natural
lighting source (window) instead of electric light.
Accommodation-related product suggestions
Note: Many products identified as accommodations are commercially available. Shop wisely before
purchasing a product as an accommodation by comparing price and warranty, necessary maintenance, availability, and usability.
Most home improvement stores, or other lighting specialty stores should have the following items:
- Full spectrum lighting
- Other alternative lighting (non-fluorescent lighting, task lighting, etc.)
Any retail store where electronics are sold should offer the following products:
- 2-way radios
- Alarm clock radios
- Alarm watches
Protective gear and safety equipment can be purchased commercially or e-commercially at contracting,
industrial, or home improvement stores, or by mail order catalog. The Epilepsy Foundation may also
have some recommendations in this regard.
- Head protection
- Eye protection
- Hand protection
- Safety rails
- Machine guarding
- Fall protection (safety harness)
- Anti-fatigue mats
Stories of successful accommodations from the Job Accommodation Network: Some examples of effective workplace accommodations for employees with epilepsy:
- An administrator with generalized tonic epilepsy needed an emergency alerting system as an accommodation. JAN suggested using a two-way radio. JAN suggested creating a plan of action. The approximate accommodation cost: $100.
- A laborer with epilepsy wanted to make her work area safe in the event of a seizure. JAN suggested installing machine guarding around her machine and placing rubber matting on the floor around her work station.
- An educational consultant with partial complex epilepsy has driving restrictions. JAN suggested allowing another team member to drive to site-visit locations, working from home on non-site-visit days, communicating via email, and submitting paperwork electronically.
- A telemarketer with partial complex epilepsy had difficulty learning new tasks after epilepsy surgery. JAN suggested retraining, allow use of "yellow highlighted" procedural manuals, and assigning one person to consistently model and mentor work activite of the employee. The approximate accommodation cost: $60.
- A cook with infrequent generalized tonic-clonic seizures was concerned about potential burns while working. Light flame retardent clothing and gloves were recommended in order to prevent burns.
For additional examples, visit: http://www.jan.wvu.edu/media/epilepsy.html
General Job Accommodation Resources
The Job Accommodation Network (JAN) is a free consulting service that provides information about job
accommodations, the Americans with Disabilities Act (ADA), and the employability of people with disabilities.
State Vocational Rehabilitation Office
Every state has a vocational rehabilitation agency that provides vocational assessment, counseling, job training and placement, advocacy, and often a variety of support or medical services critical to a person’s employability. Look for the Office of Vocational Rehabilitation Services under state listings in your telephone directory.
Office of Disability Employment Policy
200 Constitution Avenue, NW, Room S-1303
Washington, DC 20210
The Office of Disability Employment Policy (ODEP) is an agency within the U.S. Department of Labor. ODEP provides national leadership to increase employment opportunities for adults and youth with disabilities while striving to eliminate barriers to employment.
ADA Technical Assistance Centers (regional Disability and Business Technical Assistance Centers), located across the United States, provide information about reasonable accommodation. The centers' specialists can answer most questions you or your employer may have about ADA. Call 800.949.4232.
Equal Employment Opportunity Commission
1801 L Street NW
Washington, DC 20507
Toll Free: 800.669.4000
The EEOC was established by Title VII of the Civil Rights Act of 1964 and began operating on July 2, 1965. The EEOC is the enforcing agency for several discrimination-related federal statutes, including Title I of the Americans with Disabilities Act of 1990 (ADA), which prohibits employment discrimination against individuals with disabilities. The EEOC's 800-number routes individuals to their closest field office. (Note: State Human Rights Commissions can often act more expediently in employment discrimination cases under relevant state legislation.)
ABLEDATA provides objective information on assistive technology and rehabilitation equipment available
from domestic and international sources to consumers, organizations, professionals, and caregivers within the United States. We serve the nation's disability, rehabilitation, and senior communities.
Epilepsy-Specific Job Accommodation Resources
Epilepsy Foundation of America
8301 Professional Place
Landover, MD 20785
Toll Free: 800.332.1000
The Epilepsy Foundation operates a Career Support Center, a free informational online tool that assists individuals with epilepsy in their employment searches. It offers guides on job preparation and job search sites, suggestions on disclosing information about epilepsy in the workplace and other resources. For information, go to: www.epilepsyfoundation.org/programs/csc.cfm. Job seekers can also contact the local affiliate of the Epilepsy Foundation to inquire about job openings in the regions served by these affiliates or about other employment programs run by these agencies. Contact information for all affiliates around the country can be obtained from: www.epilepsyfoundation.org/aboutus/AffiliateLookup.cfm.
The Foundation also operates the Jeanne A. Carpenter Epilepsy Legal Defense Fund. The Fund provides legal guidance on employment matters and other issues to individuals experiencing epilepsy-related discrimination, along with referrals to a nationwide network of cooperating law offices, which provide these individuals legal representation (some or all services are provided free of charge). For information, see: www.epilepsylegal.org, or call 1.800.332.1000.
U.S. Equal Employment Opportunity Commission, Enforcement Guidance: Reasonable Accommodation and Undue Hardship Under the Americans with Disabilities Act (2002), available at: www.eeoc.gov/policy/docs/accommodation.html.
For information on tax credits available to employers for providing accommodations, reference: